Syracuse, N.Y. -- The state has fined Cayuga Medical Center $8,000 because a doctor at the Ithaca hospital operated on the wrong side of a patient’s back during spinal surgery.

The doctor and others involved in the operation did not follow all the hospital’s rules for verifying the correct surgery site before cutting the patient, according to a state Health Department report.

Although the incident happened in 2008, Cayuga settled the matter with the state Health Department in October. The department posted a notice of the fine on its website earlier this month.

The patient, a woman, was getting surgery to relieve back pain, said Dr. David Evelyn, Cayuga’s vice president of medical affairs. The surgeon operated on the right side of her back to remove material from a disc, he said. A disc is one of the elastic cushions located between the vertebrae in the spinal column. Just before completing the operation, the mistake was discovered and the surgeon did the operation on the left side, the correct location. The doctor removed the entire disc, Evelyn said.

The doctor and patient were not identified.

Doctors and other hospital personnel are supposed to take a number of steps to prevent these types of errors, including marking the operation site with a marker and taking a time out before surgery to double-check everything.

The surgeon did not write the words “left” on the patient’s back as required, according to the state. Also, a hospital employee scheduling the surgery failed to note the correct location in records.

“We did take decisive corrective action against all those involved,” Evelyn said. He declined to say what specific action was taken.

Evelyn said the patient was not harmed in the mishap and got pain relief on both sides of her back. “She was actually pleased the surgeon did the procedure on both sides at the same time,” Evelyn said. The plan was to do surgery on one side to see if it would relieve the pain. The patient might have ended up needing to get surgery on the other side anyway if the first operation did not work, he said.

The state Health Department and the Joint Commission, the agency that accredits hospitals, have focused more attention on wrong side and wrong site surgery in recent years. Medicaid, Medicare and many other insurers refuse to pay for these operations when such blunders happen. These mistakes are known as “never events,” because health experts say they are preventable and can cause serious harm or death. The Joint Commission says even wrong side surgeries that don’t result in patient harm are worrisome because they may be symptoms of widespread problems in the way hospitals provide care.

“This for us was a watershed moment,” said Dr. Rob Mackenzie, Cayuga’s president and CEO. The incident prompted Cayuga to reevaluate patient safety throughout the entire hospital, he said. It started mandatory patient safety training for employees and established groups of doctors, nurses, therapists and other clinicians in every department who monitor safety issues in their areas daily.

Cayuga also now sends an observer into the operating room to watch and make sure everyone is following patient safety rules, Evelyn said.

“It’s really the culture you have to change,” Evelyn said. “You can have all the protocols, rules and regulations, but unless you change the culture so that people are doing it for positive reasons, someone is going to try to cut a corner.”